Join the Coolest School of Rock in the Universe!

Planet Rock School of Music Performance is accepting new students for our Fall 2009 season and Spring 2010 show seasons. Fill out the form below and one of our music directors will contact you to answer all of your questions about our rock school programs, set up a tour of the school & performance studio, and meet our directors and instructors.

(*) Required Fields

 

Student's First Name (*):

Student's First Name (*): :: Please enter the student's first name.

 

Student's Last Name (*):

Student's Last Name (*): :: Please enter the student's last name.

 

Parent's Full Name (*):

Parent's Full Name (*): :: Please enter the parent's first and last name.

 

Home Address:

Home Address: :: OPTIONAL: Please enter your home street address.

 

City:

City: :: OPTIONAL: Please enter your city.

 

State:

State: :: OPTIONAL: Please enter your 2-character state.

 

Zip Code:

Zip Code: :: OPTIONAL: Please enter your 5-digit zip code.

 

Home Phone (*):

Home Phone (*): :: Please enter your home phone number as xxx-xxx-xxxx.

 

Parent's Cell Phone (*):

Parent's Cell Phone (*): :: Please enter your cell phone number as xxx-xxx-xxxx.

 

Parent's E-Mail Address (*):

Parent's E-Mail Address (*): :: Please enter the parent's e-mail address.

 

Preferred Contact Method (*):

Home Phone
Cell Phone

Preferred Contact Method (*): :: Please enter your preferred method of contact for one of the Planet Rock directors.

 

Select the student's instrument(s) and talents (*):

Guitar
Bass
Drums
Vocals
Keyboards
Songwriting

Select the student's instrument(s) and talents (*): :: Please select the instrument(s) your son or daughter can play.

 

List other instrument(s) the student can play:

List other instrument(s) the student can play: :: OPTIONAL: Please enter any other instruments your son or daughter can plan.

 

Other performing arts interests (i.e.: Theatre, Chorus, Band):

Other performing arts interests (i.e.: Theatre, Chorus, Band): :: OPTIONAL: Let us know if your son or daughter have any other talents or interests in other performing arts.

 

Please enter the characters exactly "as shown" before you Submit (*).   

Please enter the characters "as shown" before you Submit (*). :: As a means to protect against spam, please enter the characters exactly as shown (upper and lower cases) in the provided box before you click on Submit.

 

 

NOTE: Planet Rock School of Music Performance protects the information provided and will not sell or share your information with any person or organization outside of Planet Rock Entertainment, Inc.